Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management.
2017
Background: Diabetes mellitus is a vastly prevalent metabolic
disorder with escalating global health concerns. Particularly when
mismanaged, chronic micro- and macrovascular complications may highly impair
physiological systems while immunodeficiency disposes us to infection.
Objective: We investigate infections, localized complications, and neoplasms
of the genitourinary system secondary to the chronic complications of
diabetes mellitus in males and females. Method: A comprehensive MEDLINE®
search was guided using key words relevant to diabetes mellitus and the
genitourinary system. Results: Pathogen-friendly environments may implicate
the sequelae of urinary tract and genital mycotic infections, potentially
generating necrosis, abscess, and other inflammatory complications, which
may present concomitantly with neurogenic and/or vasculogenic dysfunction to
further exacerbate an existing genitourinary condition. Manifestations of
the adrenal, renal, and genital organs and tissues are discussed as they
relate to vascular, immunodeficient, and other hyperglycemic complications
of the diabetic state. Among those, chronic kidney disease and cystopathy
are the most prevailing and detrimental. Though studies have connected
diabetes to either an increased risk of developing or poor prognosis of
bladder, renal, prostate, endometrial, and cervical cancers, the explicit
biological relationships are as of yet inconclusive. Conclusion: Despite the
availability of precise treatments to ameliorate most presently reviewed
conditions, particularly urinary tract and genital mycotic infection-related
sequelae, reversing permanent vascular damage remains a great challenge.
Leading a healthier lifestyle and managing diabetes mellitus with a
patient-centric approach from the outset are the most putative methods for
preventing critical long-term genitourinary manifestations of diabetes
mellitus.
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